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Unusual presentation of more common disease/injury
CASE REPORT
Reversible cardiac dysfunction in long-standing hypertension may be global variant of stress cardiomyopathy
  1. Anand Chockalingam,
  2. Senthil A Kumar
  1. Division of Cardiovascular Medicine, University of Missouri, Columbia, Missouri, USA
  1. Correspondence to Dr Anand Chockalingam, chockalingama{at}missouri.edu

Summary

An adult man with long-standing poorly controlled cardiac risk factors presented with acute decompensated heart failure (ADHF). Echocardiogram, cardiac MRI and catheterisation suggested idiopathic dilated cardiomyopathy, severe systolic dysfunction, ejection fraction 25% with global left ventricular (LV) dilation and apical thrombus. He responded well to diuretics and gradual uptitration of lisinopril and carvedilol. Follow-up echocardiogram in 2 months demonstrated complete recovery of systolic function, normalisation of LV size and shape with severe LV hypertrophy. This presentation is potentially a global variant of stress cardiomyopathy with recovery of LV function, highlighting the importance of appropriate imaging, catheterisation and clinical monitoring in patients with ADHF.

  • hypertension
  • heart failure

https://doi.org/10.1136/bcr-2018-225044

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    Footnotes

    • Contributors AC: evaluated the patient, managed therapy and wrote the manuscript. SAK: suggested edits to the manuscript, helped in appropriately diagnosing this rare presentation and collected the key images for publication.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.